The potential effect of iron defortification on iron-deficiency anaemia in the US population

AbstractObjectiveTo quantify the potential effect of iron defortification in the USA on iron-deficiency anaemia (IDA).MethodsMonte Carlo models were built to simulate iron nutrition in the US population. A hypothetical cohort of 15 000 persons from the general population was used in 15-year simulations to compare the prevalence of IDA with and without fortification.ResultsWith iron fortification, the prevalence of IDA was 2.4% for children aged 3–5 years, 5.4% for women aged 20–49 years, and 0.14% for men aged 20–49 years. The corresponding IDA estimates under iron defortification were 4.5%, 8.2% and 0.46%, respectively. Defortification had little effect on the distribution of iron indicators at or above the 50th percentile within each of these three groups and little effect on the distributions of iron indicators among adult men.ConclusionIron defortification is likely to increase IDA among children and women of reproductive age, but is not likely to have meaningful effects on the iron status of men or the majority of women and children.

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Iron preparations for women of reproductive age with iron deficiency anaemia in pregnancy (FRIDA): a systematic review and network meta-analysis

The Lancet Haematology ◽

10.1016/s2352-3026(21)00137-x ◽

2021 ◽

Vol 8 (7) ◽

pp. e503-e512

Author(s):

Ewelina Rogozińska ◽

Jahnavi Daru ◽

Marios Nicolaides ◽

Carmen Amezcua-Prieto ◽

Susan Robinson ◽

...

Keyword(s):

Systematic Review ◽

Iron Deficiency ◽

Iron Deficiency Anaemia ◽

Meta Analysis ◽

Reproductive Age ◽

Women Of Reproductive Age ◽

Deficiency Anaemia ◽

Anaemia In Pregnancy ◽

In Pregnancy

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Genetic contribution to iron status: SNPs related to iron deficiency anaemia and fine mapping of CACNA2D3 calcium channel subunit

Blood Cells Molecules and Diseases ◽

10.1016/j.bcmd.2015.07.008 ◽

2015 ◽

Vol 55 (4) ◽

pp. 273-280 ◽

Cited By ~ 5

Author(s):

Carlos Baeza-Richer ◽

Eduardo Arroyo-Pardo ◽

Ruth Blanco-Rojo ◽

Laura Toxqui ◽

Angel Remacha ◽

...

Keyword(s):

Iron Deficiency ◽

Calcium Channel ◽

Fine Mapping ◽

Iron Deficiency Anaemia ◽

Iron Status ◽

Genetic Contribution ◽

Deficiency Anaemia

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Prevalence of Iron Deficiency Anaemia among the Reproductive Age Group Women Attending the Unani Hospital, Bangalore, Karnataka, India

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/44851.14340 ◽

2020 ◽

Author(s):

Mazharul Islam ◽

Atiya Khan ◽

Arish Mohammad Khan Sherwani

Keyword(s):

Iron Deficiency ◽

Pregnant Women ◽

Iron Deficiency Anaemia ◽

Economic Status ◽

Cross Sectional Study ◽

Reproductive Age ◽

Age Group ◽

Cross Sectional ◽

Deficiency Anaemia ◽

Reproductive Age Group

Introduction: Iron Deficiency Anaemia (IDA) is the most widespread micronutrient deficiency. Globally, nearly two billion people are affected by anaemia. This disease most often affects children, women of child-bearing age, and pregnant women. Nearly half of the pregnant women in the world are estimated to be anaemic. Its prevalence varies according to region and socio-economic conditions. The majority of those who are anaemic live in developing countries where the problem is exacerbated by limited access to inadequate resources and appropriate treatment. Aim: To find out the prevalence of IDA in the reproductive age group women and its associated factors. Materials and Methods: This hospital based, cross-sectional study was conducted among 400 females, of age group 15-49 years. After obtaining the written informed consent, eligible subjects were inquired about socio-demographic variables, socio-economic status, anthropometric measurements and risk factors. Required investigations were done. All the information was recorded on the semi-structured schedule form. Chi-square/Fisher’s-exact test was used to find the significance of study parameters on categorical scale between two or more groups. Results: Prevalence of IDA was found to be 42% (168/400). Prevalence of IDA was significant with habitat (p=0.0180), exercise (p=0.0004), amount of blood loss during menstruation (p<0.0001), duration of flow during menstruation, (p=0.0020), consumption of fish (p=0.0002), consumption of legumes (p=0.002), consumption of green leafy vegetable (p<0.0001). Conclusion: Results confirmed an increased prevalence of IDA in women of reproductive age group.

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A descriptive study of New Zealand midwives' primary care management of iron status in pregnancy and the postpartum period

10.26686/wgtn.17014172.v1 ◽

2021 ◽

Author(s):

◽

Esther Calje

Keyword(s):

New Zealand ◽

Iron Deficiency ◽

Iron Deficiency Anaemia ◽

Clinical Guideline ◽

Iron Status ◽

Secondary Analysis ◽

Descriptive Study ◽

Deficiency Anaemia ◽

End Stage ◽

Maternal Iron

<p>Background: Globally there is no consensus on haemoglobin (Hb) parameters that define maternal anaemia. Therefore it is difficult to distinguish physiological anaemia of pregnancy from anaemia associated with pathology. Low maternal iron status is associated with adverse outcomes, although the evidence is difficult to interpret. Non-anaemic iron deficiency requires prevention and treatment, before end stage iron deficiency anaemia. Increases in serum ferritin (SF) secondary to inflammation, gives misleading results of iron stores if not tested with C-reactive protein (CRP). Given the complexities, how do Lead Maternity Carer (LMC) midwives in New Zealand manage anaemia and iron deficiency, without a clinical guideline? Methods: In this descriptive study, quantitative data was retrospectively collected from September-December 2013, from LMC midwives (n=21) and women (n=189), in one New Zealand area. Main outcomes assessed were women’s iron status. Anaemia was defined as Hb <110g/L in the first trimester, <105g/L in subsequent trimesters, and <100g/L postnatally. Iron deficiency was defined as SF <20 μg/L, if CRP<5mg/L. A secondary analysis of iron status and body mass index (BMI) was undertaken. Results: Of the 186 women who had Hb testing at booking, 46% did not have ferritin tested concurrently. Of the 385 ferritin tests undertaken, 86% were not tested with CRP. Despite midwives prescribing iron for 48.7%, and recommending iron for 16.9% of second trimester women, 47.1% had low iron status before birth. Only 22.8% had Hb testing postpartum, including 65.1% (of 38) with blood loss >500mls. Results of a secondary analysis showed a significant difference (p=.05) between third trimester ferritin levels in women with BMI ≥ 25 (Md SF 14 μg/L) and BMI < 25 (Md SF 18 μg/L). Conclusions: Inconsistent testing of ferritin made it difficult to assess maternal iron status, especially without concurrent testing of CRP. Midwives may not understand and recognise the progression from iron sufficiency to end-stage iron deficiency anaemia. Even without further research this small study may indicate the need for improved education for midwives, and a clinical guideline. More complex studies on the prevalence in New Zealand, BMI and iron status, and maternal outcomes especially in the postpartum period, are warranted.</p>

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EP.WE.548The prevalence iron deficiency anaemia in patients with oesophago-gastric cancer

British Journal of Surgery ◽

10.1093/bjs/znab308.063 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Catherine McCollum ◽

Khurram Khan ◽

Rongkagorn Chuntamongkol ◽

Matthew Forshaw

Keyword(s):

Gastric Cancer ◽

Iron Deficiency ◽

Iron Deficiency Anaemia ◽

Iron Level ◽

Serum Iron Level ◽

Blood Profile ◽

Deficiency Anaemia ◽

Adult Men ◽

High Prevalence ◽

Post Menopausal

Abstract Aims Blood loss from the gastrointestinal tract is the most common cause of iron deficiency anaemia (IDA) in adult men and post-menopausal women. Up to 10% of patients with IDA have underlying gastrointestinal cancer. The aim of this study was to investigate prevalence of IDA in patients with oesophago-gastric cancer. Methods A retrospective cohort study of all newly diagnosed oesophago-gastric cancers (adenocarcinoma and squamous cell carcinoma) and high grade dysplasia discussed at tertiary multi-disciplinary team meeting between October 2019 and September 2020. Electronic case notes and blood profile at presentation, including ferritin and serum iron level, were analysed. Patients who did not have blood profile within three months of presentation were excluded. Results A total of 349 patients were identified, 12 were excluded due to missing data. 226 (67.1%) were male and the mean age was 69.7 ± 11.7 years. 260 (77.2%) were referred from primary care. After initial investigations, 256 (76.0%) were oesophageal cancer, 248 (73.6%) were adenocarcinoma, and 134 (39.8%) were metastatic at presentation. 128 (38.0%) patients were anaemic: 30 (23.4%) microcytic, 88 (68.8%) normocytic and 10 (7.8%) macrocytic. 98 (76.6%) anaemic patients had ferritin and/or iron levels checked. Analysis of these identified 63 (49.2%) patients with bloods consistent with IDA: 22 (34.9%) microcytic, 40 (63.5%) normocytic, and 1 (1.6%) macrocytic. Conclusions This study confirms that while there is high prevalence of anaemia in patients presenting with oesophagi-gastric cancer, IDA was diagnosed in only half of these. The predominant form of anaemia identified in these patients is normocytic.

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"A clinical study to assess efficacy of rasapachaka kashaya in rasapradoshaja vyadhi - panduroga (iron deficiency anaemia) in females in reproductive age."

National Journal of Research in Ayurved Science ◽

10.52482/ayurlog.v8i02.556 ◽

2020 ◽

Vol 8 (02) ◽

Author(s):

Sonal Lohiya

Keyword(s):

Clinical Study ◽

Iron Deficiency ◽

Iron Deficiency Anaemia ◽

Modern Science ◽

Reproductive Age ◽

Muscle Cramp ◽

Deficiency Anaemia ◽

Blood Indices ◽

Significant Difference ◽

Loss Of Appetite

Background: Pandu is a Rasa Pradoshaja Vyadhi described by Acharya Charaka. Pandu causes extreme debility as it is dominated by the symptoms like Palpitation, Fatigue, Dyspnoea on exertion etc, due to the vitiation of Rasa and Rakta Dhatu, which are the essential factors for nourishment of body. There is a correlation of Pandu with Anaemia of Modern science. Females in reproductive age are more susceptible for Iron Deficiency Anaemia due to regular menstrual flow and dietary inadequacies and ultimately suffer complications in pregnancy as well in delivery. The present clinical study was conducted to assess efficacy of Rasapachaka Kashaya in Rasapradoshaja Vyadhi - Panduroga (Iron Deficiency Anaemia) in females in reproductive age. Methods: Total 30 female patients of Panduroga in the age group 18-45 years were selected randomly. The study subjects were given Rasapachaka Kashaya in the dose of 1 gm twice a day after meals. Total study duration was of 90 days and assessment was done before initiation of study and at the end of every month. Results: The relief in symptom scores such as Panduta (Pallor), Hrutspandan (Palpitation), Shunakshikut (Periorbital oedema), Daurbalya (Weakness), Hatanal (Loss of Appetite), Arohanayas (Exhaustion during climbing), Pindikodveshta (Calf muscle cramp), Aruchi (Anorexia), Shrama (fatigue), Bhrama (giddiness) and Nidralu (Sleepiness) symptom was statistically significant (p < 0.01). Statistically significant difference was observed in objective parameters such as Haemoglobin level and RBC count (p < 0.05 and < 0.001 respectively) also in PCV and MCMC after 3 months of treatment. No significant improvement was noticed in blood indices such as MCV and MCH. WBC count found to be improved to significant level whereas ESR showed decline to statistically significant level. No significant change in Platelet count was seen over a period of three months, i. e. completion of treatment. Conclusion: The Rasapachaka Kashaya is found to be effective in the management of Rasapradoshaja Vyadhi– Panduroga in females in reproductive age.

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Reducing iron deficiency anaemia due to heavy menstural blood loss in Nigerian rural adolescents. Reprinted from Public Health Nutrition Volume 1 (4), 249–257, 1998

Public Health Nutrition ◽

10.1079/phn2005818 ◽

2005 ◽

Vol 8 (5) ◽

pp. 451-460

Author(s):

Fiona Barr ◽

Loretta Brabin ◽

Shola Agbaje ◽

Feikumo Buseri ◽

John Ikimalo ◽

...

Keyword(s):

Iron Deficiency ◽

Serum Iron ◽

Iron Deficiency Anaemia ◽

Iron Status ◽

Transferrin Saturation ◽

Cultural Barriers ◽

Menstrual Disorders ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Deficiency Anaemia

AbstractObjectiveMenstrual disorders are common in young women, and heavy menstrual blood losses (MBL) are an important cause of anaemia. Menstrual morbidity normally goes untreated in developing countries where cultural barriers also serve to make the problems. We investigated the prevelance of menstrual morbidity, and measured MBL and its relationship to iron deficiency in a rural adolescent population. The rationale was to assess whether or not reducing heavy MBL could be part of a strategy to reduce iron deficiency anaemia.SettingRural village in south-east Nigeria.DesignCross-sectional survey.SubjectsThe studdy included all non-pregnant, unmarried nulliparous girls (< 20 years) who had menstruated, and who lived in K'Dere village.MethodsA field worker allocated to each girl completed a questionnaire, and supervised recovery and collection of soiled pads and ensured blood sampling. MBL was measured using the standard alkaline haematin method. Haemoglobin (HB), serum iron, transferin saturation and protoporphyrin levels (ZPP) were also measured.Results307 girls completed MBL measurements; 11.9% refused to participate. 12.1% had menorrhagia (> 80 ml);. median MBL was 33.1 ml. Menorrhagia was more frequent in girls who had menstruated for > 2 years (p = 0.048), and had longer duration of meneses (p < 0.001). Iron status as measured by haematocrit, serum iron, transferrin saturation and ZPP values was inversely related to MBL. Neither height nor body mass index for age was associated with current iron status.ConclusionsThe level of menorrhagia detected (12%) may be an ‘expected’ level for a condition which often has no underlying pathology. Heavy MBL is one of the most important factors contributing to iron deficiency anaemia. Measures are needed to alleviate menstrual disorders and improve iron status. Oral contraceptives can be part of a strategy to reduce anaemia, particularly for adolescents at high risk of unwanted pregnancies.

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Association between consumption of black tea and iron status in adult Africans in the North West Province: the THUSA study

British Journal Of Nutrition ◽

10.1017/s000711450889441x ◽

2008 ◽

Vol 100 (2) ◽

pp. 430-437 ◽

Cited By ~ 10

Author(s):

P. S. Hogenkamp ◽

J. C. Jerling ◽

T. Hoekstra ◽

A. Melse-Boonstra ◽

U. E. MacIntyre

Keyword(s):

South Africa ◽

Iron Deficiency ◽

Serum Ferritin ◽

Iron Deficiency Anaemia ◽

Iron Status ◽

Black Tea ◽

Tea Consumption ◽

Deficiency Anaemia ◽

North West ◽

The North

The association between black tea consumption and iron status was investigated in a sample of African adults participating in the cross-sectional THUSA (Transition and Health during Urbanization of South Africans) study in the North West Province, South Africa. Data were analysed from 1605 apparently healthy adults aged 15–65 years by demographic and FFQ, anthropometric measurements and biochemical analyses. The main outcome measures were Hb and serum ferritin concentrations. No associations were seen between black tea consumption and concentrations of serum ferritin (menP = 0·059; womenP = 0·49) or Hb (menP = 0·33; womenP = 0·49). Logistic regression showed that tea consumption did not significantly increase risk for iron deficiency (men: OR 1·36; 95 % CI 0·99, 1·87; women: OR 0·98; 95 % CI 0·84, 1·13) nor for iron deficiency anaemia (men: OR 1·28; 95 % CI 0·84, 1·96; women: OR 0·93; 95 % CI 0·78, 1·11). Prevalence of iron deficiency and iron deficiency anaemia was especially high in women: 21·6 and 14·6 %, respectively. However, the likelihood of iron deficiency and iron deficiency anaemia was not significantly explained by tea consumption in sub-populations which were assumed to be at risk for iron deficiency. Regression of serum ferritin levels on tea consumption in women ≤ 40 years, adults with a daily iron intake ≤ 5·80 mg and adults with ferritin levels ≤ 26·60 μg/l, respectively, showedPvalues in the range of 0·28–0·88. Our findings demonstrate that iron deficiency and iron deficiency anaemia is not significantly explained by black tea consumption in a black adult population in South Africa. Tea intake was also not shown to be related to iron status in several sub-populations at risk for iron deficiency.

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